| NPI | 1760601991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN S PETROVER Doctor 561-364-0013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: FL DN14233) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |